Group Brings SDOH Coding Effort To HL7 FHIR Program

For the last few years, a growing number of healthcare organizations have been integrating information on social determinants of health into their population health management efforts. In fact, survey results published in early 2018 concluded that 80% of the organizations they surveyed had begun to track and use SDOH data.

Now, in another sign that SDOH data has arrived, HL7 has announced that a SDOH-focused group will join its HL7 FHIR Accelerator Program, working alongside existing initiatives such as Argonaut and Da Vinci. And while it’s too soon to tell what results it can achieve, it’s probably fair to call this news at least a modest milestone in the progress toward universal use of SDOH information in healthcare settings.

The announcement follows related news from the American Medical Association and UnitedHealthcare, which said earlier this year that they had worked together on the creation of about 2 dozen new ICD-10 codes related to SDOH, with an ultimate goal of combining them with traditional medical data. At the time, this seemed interesting, but perhaps not profoundly important in and of itself.

But The Gravity Project may be more pivotal in the emergence of this trend, at least if it can reach even some of its ambitious range of goals. Its members are shooting for a broad range of results, including creating coding standards for SDOH data capture in EHRs and fostering the use of such data in patient care, care coordination, value-based payment, clinical research and population health.

The group’s initial catalyst was the Social Interventions Research and Evaluation Network (SIREN) at the Center for Health and Community at the University of California at San Francisco. SIREN’s sponsors include the Robert Wood Johnson Foundation and EMI Advisors.

Since then, The Gravity Project’s has attracted its own launch sponsors, which include the American Academy of Family Physicians, The Blue Cross Blue Shield Association and AmeriHealth Caritas.

The Gravity Project’s process, which kicked off in 2017, is focused on the following objectives:

  • Developing use cases to support documentation for screening, diagnosis, treatment/intervention and planning activities with EHRs and other systems
  • Identifying common data elements and associated value sets to support these use cases
  • Establishing a consensus-based set of recommendations on how to best capture and group such data elements for interoperable exchange and aggregation
  • Creating an HL7 FHIR Interoperability Resource Implementation Guide based on the use cases and associated data sets

More than 500 experts are already involved in the Gravity Project, including clinical and community-based provider groups, payers, health technology developers and standards organizations. At present, membership in the Project is open to anyone.

Of course, the mere existence of a working group does not an established data set make. My guess is that it will take at least a year or two before we see major progress in fostering SDOH data uses cases, data standards and (especially) interoperability. However, if interoperability is a key goal, there are few better places to pursue it than within HL7.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.